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tv   International Programming  CSPAN  January 10, 2011 12:00am-12:30am EST

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>> speaker of the house john boehner spoke this morning in ohio about the attack on arizona representative gabrielle giffords and others outside a safeway store in tucson, arizona yesterday. here are his remarks. >> good morning. our thoughts and prayers of the house and nation always congressman giffords and her family. we are also praying for the families of judge roll and all those who were taken from us yesterday so senselessly. i directed that the flags on the house of the capital be
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flown at half mast in honor of gabe's death in the line of duty. and attacked on one who served is an attack on all who serve. such acts of violence have no place in our society. i want to commend the federal, state, and local officials for all of their efforts. i have told the fbi director at the house stands ready to assist in anyway possible. the coming week has been postponed so that we can take necessary action regarding yesterday's events. announce a revised schedule. to the members of the house and their staffs, i ask that on the
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sabbath day that we keep gaby and her staff in our thoughts and prayers. public service is a high honor, but these tragic events remind us that all of us in our roles in service to our fellow citizens comes with the risk. not, and wilma, deter us from our our constituents and to fulfill our oaths of office. must be allowed to stop us from our duty. >> speaker boehner says the house will meet in a pro forma session on tuesday. all significant legislative votes will be postponed a week. on wednesday the house is expected to approve a resolution honoring the victims of the shooting in tucson. a florida represented was a
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guest on "meet the press." here is a brief portion of her comments. >> every indication that she is showing full strength. from what i was told by her staff last night, she woke up and responded to mark's voice, her husband, and then they sedated her again. gabrielle giffords is the most open, warm, and sweet woman. the best way to describe her is that she is the kind of person that tries to see the good in everyone. even when she is in the midst of the kind of strife that is going on in southern arizona with the immigration laws and the battleground that arizona
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has been, she really always looks on the bright side. >> surgeons at university medical center in tucson, ariz., said today that she remains in critical condition but is responding to simple commands after being shot yesterday in her home district. they also spoke about the condition of the other victims in this 25-minute briefing. >> good morning, everyone, and thank you for being here. my name is kevin burns and i am the interim ceo at the university of arizona health care. it is the parent of university medical center where this level one trauma center is located. i will turn the microphone over to our front line doctors in a few minutes, dr. peter rhee. we have 10 patients in the
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aftermath of yesterday's tragedy. before i do that, i do want to make a few brief comments. i promise i will be brief. the first responders, the flight crews and the ambulance crews, you all made a difference and you saved lives. i want to thank the trauma teams. i always held -- i have always held our people here in the highest regard. i have never been so proud in my life as i was yesterday when you rose to the occasion in almost combat conditions. i also want to thank our emergency physicians who rose to the occasion yesterday to help out in this crisis.
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all of our nurses and our staff. that includes our social workers, are clergy, and all of our support group. yesterday was a challenging day. for tucson, the state of arizona, and the nation, but we will get through this. i am convinced of that after i saw the way people pulled together yesterday. in a minute i will turn the microphone over to dr. rhee. we plan to do daily updates at 10:00 a.m. on standard time. we will hang around if you have questions afterwards. for now, i would like to -- i would like to thank the mayor for being with us here today. also the dean of the college of medicine for joining us here today and i would like to introduce president robert shelton, the president of the university of arizona. he would like to make a few brief remarks and then he will turn it over to dr. peter rhee. >> thank you very much, kevin. i will be brief because the
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individuals you want to hear from are the gentlemen on my right in the white coats. i also want to knowledge the first responders, all who were engaged in a critical time line that occurred from the first incident to getting people into the operating room and in the hands of these exceptional individuals. another individual i want to mention here is the chair of surgery. he will have a word or two to say. he joined us about three years ago and has built an extraordinary team in surgery and trauma. you will hear from them later on. i think it is safe to say that this team is second to none, and the timeline, the rapid response they had here that saved lives. you'll hear from the chief of
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neuroscience and your surgery and doctors rhee, chief of trauma, critical care, an emergency surgery. i offer our appreciation and thanks for the remarkable skills of these individuals. the university of arizona is proud to be associated with ua health care and to play a role with this. now all it is my pleasure to introduce the chair of surgery here at the university of arizona. >> i will be very brief periods is obviously a sad day for the families, for the community, for the state of arizona and for the nation. our hearts go out to the families of the victims. this is something we are rarely prepared for as we think, but
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yesterday we were fortunate enough to have the doctors here. within an hour we had six patients in the operating room. we had for trauma surgeons in the operating rooms, two neurosurgeons were here, and other drastic surgeon was here. to 38 minutes for the most critically injured person to be transferred to the operating room. it is my great pleasure to introduce to individuals who were crucial in the recovery of the victims. dr. peter rhee who has served in both afghanistan and iraq the readiness and willingness and people -- of people to support us, not just the positions but the people in operating room and everyone else did a marvelous job estate. i think our community can be proud of what happened here
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within a very short time yesterday. >> thank you very much. i am the from a medical director here at the university of arizona medical center. we suffered a tragedy here. i never thought i would experience something like this in my own backyard. i have a lot of sympathy and empathy for the patients who came through here and their families in a very trying time for all of us. again, our condolences to the patients and their families. we had accommodation in total of 11 patients that we had seen here at the hospital. the first one was a 9-year-old child who came in dead. we tried to resuscitate her including surgery, but we were not able to resuscitate her and bring her back.
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we had five patients who were brought to us in serious condition. of those patients, we had an additional five patients who were not in such a dire situation, but we ended up doing six surgeries. it included a variety of things in that,-combat scenario. we are doing things in the chest, abdomen, the arrested and also orthopedic in nature as well. as of this morning we are happy to stay that only one person remains in critical condition and i think we will be able to discuss that with a little more detail. the rest have been moved out of the i see you -- out of the icu. we all know that the one patient in serious condition right now is congresswoman giffords.
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i would turn over to the chief of your surgery who can give you more information. >> i am the chief of nearer surgery here, and i want to reiterate that our thoughts and prayers go out to the families of all those affected here. that reversed reiterate what a lot of people said, which is the incredible effort here. it is a team effort at a level one trauma center. that kind of resource enables this effort. everything from the e are physicians, support staff and nursing, dr. rhee and his team that were able to get the patients into surgery within 38 minutes.
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this kind of effort, this outcome was really possible because of these resources. let me take back to the sequence of events coming to clear some of the information out there. congress woman giffords was shot in ahead. when she arrived here, the reports were that she was able to follow commands, responsive to verbal communications. we quickly got her back to the zero are within 38 minutes, as you heard. -- daughter back to the operating room. we went to work routine procedure for this type of injury. that consisted of controlling the bleeding which was not severe or excessive. our next objective was to take the pressure of the brain by removing the bone fragments that were caused by the bullet tractor as well as some additional bone to allow the brain to relax. lastly, we removed any small parts of the bottle lost brain, and i am happy to say we did not have to do much of that. -- small parts of devitalized brain. the things that are most concerning to us or if the bullet crosses from one
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hemisphere of the brain to the other. if it crosses the the geometric center of the brain. i am happy to say that those are not the case in this instance. because of that, congresswoman giffords is able to communicate with us this morning for following simple commands. we are very encouraged by that. we are still in critical condition. brain swelling at any time can take a turn for the worse, but i am cautiously optimistic. dr. rhee will talk about the critical care management that will be so vital in the next couple of days. >> she was not verbalizing when she came in before the surgery. after surgery she was under anesthesia. it is hard to say she was in a coma-type state. we were happy and optimistic
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because eventually over the course of the evening she was able to follow simple commands. this is very early and of course we do not know what is going to happen in the beecher. we will be those updates as we go along. we have been very happy with the hospital course, of blood transfusions have worked well. things are going very well and we are all very happy at this stage. i will open up the floor for questions. >> as you verbalized at all? [unintelligible] >> what can i get into too much more detail than what we already have. i can tell you the right now with the type of surgery she cannot open her eyes at this moment -- at this point and she cannot speak at this point. >> it could be anything as
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simple as please squeeze my hand or point with two fingers. we take those kind of simple commands for granted, but they implied a very high level of functioning in the brain. >> this was not a little brazing wound to the brain. it traveled the entire length of the brain on the left side. the neurosurgeons save her life. with the function that she had before the surgery it tells us how much injury the bullet did, but the fact that she had a lot of [unintelligible] of course, as time goes on, at the effects from the bullet itself will have some degeneration of brain cells and matter. we have to see what happens later on.
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>> for the first 24 hours, is that a good sign because of the first 24 hours being critical? >> one of the most important things is how she was before surgery. in gunshot wounds, we have the damage done by the bullet when it traverses. then there is secondary injury, the injury caused by the subsequent swelling and changes. that we can try and mollify. if she comes in and is able to follow commands, that is very important. >> where did the bullet hit? >> it went through on the left side, basically from the back to the front. in most people, the left side controls their right side strength, a sensation. in most people at also
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controlled their speech functions, their ability to understand and make a speech. that includes the ability to understand simple commands. >> how long was the surgery? >> the surgery took about two hours. there was a little bit of extension at the end of the case. one of the factors was affecting the i saw it -- the i saw it -- the eye socket. >> time recovery, how long will recover like this take? >> we did not speculate on the degree of recovery. we have seen the whole gamut, and it really is not productive. we talk about recovery in your surgery it in terms of months or years. we do not close the book until we are several years out. it is not uncommon after these
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kind of injuries to be in intensive care for least a week and may be in a hospital for two or three weeks. no doubt there will be a rehabilitative phase that could take weeks or months. beyond that, setting an actual date is not productive. [unintelligible] >> it will be how her brain functions and it is important for us to get -- the drugs that we use are very manageable and short lasting so we can get a really good assessment. when we wake her up for examinations, how she responds is what we will be able to base our prognosis on. everybody is cautious about what they are calling it, but i
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am optimistic. overall this is about as good as we are going to get. when you get shot in the head and the bullet goes through your brain, the chances of the living are small and the chances of waking up and actually following commands is actually much smaller than that. so far this is been a very good situation. hopefully it will stay that way. it is still very precarious at this time. [unintelligible] >> we always do cat scans. we had a cat scan before the first surgery. i cannot go into the details for obvious patient privacy issues, but the cat scan showed the track of the bullet through the left hemisphere. it showed that it was not through some of those critical trajectories that would have made recover much more difficult. >> what happens when the brains wells?
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but when the brain swelled? >> it is like when you sprain your neat and the fluid collects and causes tremendous amounts of pain. the blood flow to the neurons and brain cells it compromised. in this kind of situation, the doctor took the skull often kept it off. right now on have a brain she does not have a skull. it is preserved in the hospital and weaken reimplant that later on. that is part of the progress that was made in narrow surgery. during the last decade the experiences we learned from the military as well about letting the brain not be constrained within the cavity held a lot and it is an important factor here as well. >> if we do run into trouble in the next few days we develop
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tools so we can use to drive out the brain we can literally put a tube into the center of the brain to measure pressure and then relieve the pressure is necessary. but because she looks good right now, there is no need for that. brain swelling is really the biggest threat at this point. >> did it come out her forehead, above her i? >> the doctors are very leery -- it looked fairly clear to me that it most likely did go from the back to the front. she is in a medical, right now. -- she is in a medical coma right now. [unintelligible] >> we turn of the sedation. that allows her brain to keep then function at its highest
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level. >> it puts you asleep like an anesthetic does. she is not suffering from being operated on and also being on a ventilator. >> [unintelligible] explaining how your brain can function at near normal levels [unintelligible] compensating in some way through >> because this question borders on speculation i do not want to go into too much detail. there are obvious areas of the brain that are less tolerant to intrusion.
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it does not mean we are using 10% of our brain or that other parts of our brain are not important. it means that the brain is able to recover from those injuries as opposed to other areas. i do not want to go down this speculation road. at the same time, we are cautiously optimistic. >> with a penetrating brain injury is always surprising that you think any bullets going into the brain means instant death. there is a lot of capacity that the human brain has with the ability for us to compensate. >> what do you treat her still being alive to? >> i attributed to about five things. one, the paramedics got her to us quickly. they did not do a lot of intervention. we have a system in place what
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-- that works like a finely tuned machine. they got her here quickly. the trauma surgeon did everything right. we got her quickly lined up and assessed and knew what injuries she had. that anesthesia step that put her to sleep in daughter ready for the surgery, all of these things including the postoperative care. it was not one particular individual. the other part of it is also luck and what the bullet actually hit when she first got hit. there were a lot of other victims that came in here. fortunately, no one that should not have died died. we were able to transfer everybody from the intensive care unit to the ward which is
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an indication of how well they are doing. we are extremely happy with the prognosis of all the other individuals. it was not just one person. the hospital with this preparation, due to their cause a practice and experience was able to pull this thing through and the medical community all contributed heavily to this. we were in a good situation yesterday. >> at any point upon her arrival did she try to speak at all? >> no, she could not speak. [unintelligible] >> this is not really a mass casualty. this is a luxury for me. this trauma center, in southern arizona we are the only one, and this is about as good as it gets.
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i am very happy to call this my home and work here. i am not a political person, i am just a public servant. sometimes when we have this kind of injuries, we have to use our drills to take off the skull and relax the brain. in this case, a lot of the fractures had done our work for us, so it was a matter of removing the larger pieces and extending that. that is probably the simplest way to say it in layman's terms. >> we typically will protect the brain with an artificial layer and enclosed the scalp over it. we will put it back when the brain has relaxed sufficiently. that may take several months. >> thank you very much for coming in your attention today. >> thank you again for coming.
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the doctors will be available for interviews. will have another medical bulletin tomorrow at 10:00 at the same location. we'll keep you apprised of any changes in the condition of any of the victims. we will keep this very open and transparent to all of you and share the information with you. at this point we are very happy to say that we have one critically injured person left and the rest of the patients are doing better. we will see you tomorrow, and if there are any questions, the doctors will be available. thank you for coming. >> fbi director robert mueller was said to head the investigation. at a news conference today he said it is premature to
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determine a motive of the suspect in custody. joining him at this briefing is that pima county sheriff. >> good morning. i think i spoke to most of yesterday. >> it is my pleasure to introduce to you director mueller from the fbi. as we told you yesterday, not only our two agencies, but all state and local agencies and balls have not -- agencies involved, have not only been working hand in hand, but are joined at the hip. the investigation is progressing smoothly. at this time, i would like to introduce director mueller from the fbi. >> thank you, sheriff.


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